Could a Name Change Increase Support for Safe Injection Sites?

How would you feel about a "safe consumption site" for drug users opening in your neighborhood? How about an "overdose prevention site"? They're the same thing, but, a new survey finds, 50 percent more people in states hit hard by addiction say they would support an overdose prevention site, compared to a safe consumption site.

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Writing here at Pacific Standard, I've mostly called them "supervised injection facilities," a term that's common in the scientific literature. However they're named, these are clinics where people may use drugs under the supervision of staff who are trained to respond to drug-related medical emergencies. In Europe, Australia, and Canada, supervised injection sites been shown to cut overdoses and deaths in the neighborhoods around them, and they don't seem to increase crime in the area. Several American cities that are struggling with overdoses are considering opening supervised injection facilities, but they're controversial; there's often local opposition to them.

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The new study, published last week in the American Journal of Public Health, suggests a name change might help supervised injection's chances among voters. Still, the majority of surveyed folks opposed them, no matter what they were called.

To see how people would react to different names for supervised injection facilities, the opinion research firm GfK surveyed a little more than 2,000 adults, weighted to be representative of the United States population. The survey-takers all read the same few sentences describing how many Americans die every day from opioid overdoses, and explaining what supervised injection sites are. In half of the surveys, however, the facilities were called "safe consumption sites" and in the other half, they were called "overdose prevention sites." The survey then asked: "Do you support or oppose the legalization of [safe consumption sites/overdose prevention sites] in your community?"

In states with the highest rates of opioid overdoses, 26 percent of survey-takers who read the text saying "safe consumption sites" supported them, while 39 percent of survey-takers who read the text saying "overdose prevention site" were supportive. Support was more common in states with fewer overdoses: 30 percent for "safe consumption sites" and 48 percent for "overdose prevention sites."

The survey reveals how much stigma drug users still face, a team of three public-health researchers from Johns Hopkins University write in the American Journal of Public Health. Indeed, it's enough for the majority of survey-takers to oppose a service that's been shown to reduce overdoses and save lives.

But it also shows that some language tweaks can help. Other organizations have tried to reduce the stigma against addiction with new ways of saying things. In 2016, the Office of National Drug Control Policy released guidelines suggesting that government agencies and the researchers they fund avoid terms such as "drug habit" (which suggests addiction is purely a matter of personal choice) and "getting clean" (which suggests drug users are dirty; folks are said to be "in recovery" instead). In 2017, The Associated Press Stylebook—which many news organizations follow—recommended that journalists avoid calling people with addictions "addicts" or "drug abusers."

Francie Diep is a staff writer at Pacific Standard, where she specializes in health and drug policy and the intersections of culture and science. Previously, she covered science, health, and science policy for Scientific American, Popular Science, and Smithsonian.

Gubernatorial races in states across the country could determine whether supervised injection sites—controversial clinics where people can safely inject drugs—will open in several U.S. cities and states where they're under consideration.